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How to Choose Your Plastic Surgeon

Posted on: March 19th, 2018
By: Office of Dr. Todd B. Koch

woman doctor in cap and face mask in surgery roomYou have made a serious decision to have a cosmetic procedure. Now, you might be wondering, how do I pick a surgeon I can trust? After all, this person will be creating changes that you will have to live with for years, if not the rest of your life. When choosing a plastic surgeon, be extremely judicious. Doing a bit of research can mean the difference between a successful procedure that instills greater confidence and an operation that produces unsatisfactory results, which can potentially lead to additional costs, time, and heartache.

Board Certified

The very first thing you should look for when choosing a surgeon is that they are board certified by The American Board of Plastic Surgery (ABPS). Legally, doctors can refer to themselves as plastic or cosmetic surgeons without having advanced training in surgery. What many people do not realize is that the state medical board does not require surgeons to be specifically trained to perform the procedures they offer. ABPS board certification ensures that the surgeon is specifically trained and experienced in plastic surgery.


When consulting with surgeons, ask about their specific training and experience in the procedure you are interested in undergoing. Find out how many of those procedures they have performed and look at their before and after pictures of previous patients. Get a feel for the surgeon’s specific style. If you are looking for a particular technique, look for a surgeon with experience in that area.


An excellent surgeon will have an impressive reputation among patients and other doctors. Ask for recommendations when beginning your search. A family member or friend might be able to point you in the right direction. Another useful resource is your general practitioner. They may be able to recommend a colleague whom they trust.

It is also beneficial for you to check the record of the surgeon for malpractice suits or complaints from former patients. State medical boards are required to make this information available to the public. In some states, this information can be found online, while you can request the record by mail in others.

Surgery Facility

Find out where the surgeon performs surgery. You want to make sure that where your surgery will be performed has an adequate medical staff and life-saving equipment if something goes wrong. Look for the facility’s level of accreditation. Accredited operating rooms will have the necessary care and equipment. Also, ask about the qualifications of the anesthetist that will be administering the anesthesia during the procedure. Make sure you have a certified registered nurse anesthetist or a board-certified anesthesiologist for your safety.

Facility Privileges

Finding out where the plastic surgeon has privileges is an easy way to verify their qualifications. To be granted privileges to operate in hospital facilities, a doctor must go through an extensive background check. Being in good standing and having opportunities at reputable hospitals is a good indication that a surgeon is well-qualified.

Customer Service

Pay attention to the initial consultation. First impressions are everything, and your comfort should be their priority. Attentive and courteous staff set the tone for the initial meeting with the doctor. During your consultation, ask as many questions as you need to without feeling rushed. Take your time. The surgeon should answer all your questions in a detailed and professional manner. Your surgeon’s overall demeanor will give you an idea of the way they will act in future interactions.

To learn more or see if Dr. Koch is the right surgeon for you, call (716) 631-1220 today!

Fillers: Fact or Fiction

Posted on: February 13th, 2018
By: Office of Dr. Todd B. Koch

woman getting dermal fillers injectionAs we age, our skin becomes more susceptible to wrinkles, fine lines, and laxity of the skin. Facial tissues start to break down after years of sun exposure and muscle movement. Luckily, there are treatments to reduce the signs of aging and keep us looking younger for longer.

One of these cosmetic treatments is fillers. Dermal fillers are facial injections applied to specific areas of the face that a patient may want to enhance. The injectables contain products, such as collagen, hyaluronic acid, and calcium hydroxyapatite. Various types of fillers are available, and each is designed for a specific purpose.

What Is Possible With Fillers?

Dermal fillers, or facial fillers, can treat a number of problems. They can correct fine lines and wrinkles, poor skin texture, and volume loss; they can also add volume to thin lips, enhance shallow contours, and improve the appearance of recessed scars.

Fillers only offer temporary results and cannot achieve the same results as a surgical facelift, brow lift, or eyelid lift. Depending on the desired results of the patient, surgical treatment may be a better approach.

What You Can Expect From Treatment

Treatments are performed in the office and last approximately 10 to 20 minutes. They consist of a series of tiny injections under the skin and require no downtime following treatment. However, it is recommended that the patient refrains from strenuous activity and excess sun exposure for 24 hours. Side effects from these treatments are typically mild swelling and bruising at the injection site. Other residual side effects subside within seven days. Due to their temporary nature, soft tissue filler treatments will need to be repeated every few months to one year, depending on individual results.

Did You Know…

  • BOTOX® Cosmetic is not a filler but a purified toxin that relaxes facial muscles; instead, fillers fill in spaces, such as with wrinkles, fine lines, and shallow folds.
  • Soft tissue injections are not considered painful. They are usually combined with lidocaine to minimize pain, or your doctor may apply a topical numbing ointment.
  • There will not be any drastically noticeable physical changes that would bring unwanted attention to your skin. Rather, the changes are mild to moderate.
  • Fillers are not permanent. If you are unhappy with the result, it will usually wear off in three months to one year.

For more information about dermal fillers or to schedule a consultation call (716) 631-1220.

3 Things That Age Your Lips

Posted on: January 8th, 2018
By: Office of Dr. Todd B. Koch

Part of face woman covering her lips with handHaving plump, smooth lips is a commonly sought-after beauty ideal. As we age, our skin loses volume due to a decrease in moisture levels and the natural degradation of collagen and elastin. This can cause thinning of the lips as well as fine lines and wrinkles around the mouth. Other factors can accelerate the effects of aging on the lips and cause them to lose volume more quickly. Fortunately, maintaining proactive lip care can help slow down the aging of the lips and even rejuvenate their appearance.

1. Genetics

The natural aging process can cause the lips to lose youthful volume, which makes you appear older. Collagen is responsible for keeping the lips plump and soft. When your body is not producing as much of this protein due to age, your lips become smaller and more prone to wrinkles.

2. Excessive Sun Exposure

It’s no secret that excessive sun exposure contributes to aging of the skin, and your lips are even more susceptible to those effects. Lips do not have melanin, which makes them vulnerable to ultraviolet (UV) rays and sun damage. Not only can UV rays break down collagen and lead to early signs of aging, but they can also increase your risk of skin cancer.

3. Smoking

Smoking affects the lips in a couple of different ways. It can trigger collagen and elastin destruction, which consequently lead to sagging skin, fine lines, and wrinkles. Additionally, smoking involves repetitive use of specific muscles around the lips, creating telltale “pucker lines.”

Preventative Measures

Although there’s not much that can be done about genetics, the other two causes of aging are entirely avoidable. Preventative measures include:

  • Wearing a broad-spectrum sunscreen with SPF 15 or higher on your lips daily
  • Quitting smoking
  • Lip-plumping products containing ingredients that make the lips swell temporarily
  • Cosmetic treatments to plump the lips:

For more information about how you can prevent early signs of aging around your lips or to schedule a lip enhancement consultation with Dr. Koch, please call 716.631.1220.

Skin Care Tips After Microneedling

Posted on: December 22nd, 2017
By: Office of Dr. Todd B. Koch

Girl Wiping Makeup Off Her FaceMicroneedling is a newer skin care trend that is great for treating acne, uneven skin tone, and scars. If you are considering the rejuvenating effects of a microneedling treatment, you should know how to care for your post-treatment skin properly. Taking care of your skin following microneedling sessions helps prevent infections and limits skin irritation so your beautiful results become noticeable faster.

Properly Cleanse Your Skin

It is important to clean your skin following a microneedling treatment, but you don’t want to over-cleanse the skin and dry it out. You can wash your face about eight hours after your initial treatment. When doing so, use a gentle cleanser and warm (but not hot) water. You can ask your microneedling technician for a cleanser recommendation if you are worried about it being too harsh. Do not use a powered cleansing brush for one week following your treatment.

Keep Your Skin Hydrated

Microneedling treatments can leave your skin feeling tight and dehydrated. Make sure you are drinking enough water and moisturizing your skin in the week following your treatment. Additionally, maintaining a good moisturizing routine will help you keep the skin-glowing effects of your microneedling treatment for longer. After microneedling treatment, our patients use a peptide aqua gel mask to deliver instant deep hydration and soothing anti-aging ingredients.

Wait to Wear Makeup

Microneedling treatments can make your skin red and irritated for several hours after treatment. This is why you should plan appropriately; don’t schedule any major activities following your procedure. We suggest remaining makeup-free for 24 to 72 hours while your skin adequately heals from your microneedling treatment.

Avoid Sun Exposure

Protecting your skin from the sun is important, even if you haven’t just undergone a skin care treatment. Your skin is likely to be extremely sensitive following a microneedling treatment. Avoid exposure to direct sunlight and wear a broad-spectrum SPF when going outdoors. Try to use a chemical-free sunscreen that is SPF 25 or higher to avoid skin irritation.

For more information on microneedling treatment and how serums can be used to enhance the results, contact us today by calling 716-631-1220.

How to Enhance Your Breasts Without Implants

Posted on: November 17th, 2017
By: Office of Dr. Todd B. Koch

Your dissatisfaction with the appearance of your breasts may have nothing to do with their size. While many people assume the only way to improve their breasts is with an augmentation, Dr. Koch offers alternative breast solutions for women whose breast problems cannot be solved just by using implants. Our techniques are tailored to meet your aesthetic needs, helping to restore an attractive and natural breast appearance.

Have a Breast Lift

Breast Lift patient of Dr. KochYou may have become dissatisfied with your breast appearance over time. Sagging breasts can be unattractive and age your appearance. Genetics and gravity will determine the extent of your breast droop, but pregnancy or weight loss can exacerbate the situation. You should consider having a breast lift if you are satisfied with the volume of your breasts, but are unhappy with their placement.


You may be a good candidate for a breast lift if you have one or more of the following issues:

  • Breast tissue that sits at or below the inframammary fold
  • Nipples that are positioned low on your breast tissue
  • Nipples that point down toward the floor
  • Areolas that are too large for your breasts

Correct Nipple Appearance

Defined nipples can help the breasts have a natural, pleasing look for many women. If you have inverted or flat nipples, you may be unhappy with the overall appearance of your breasts. Conversely, nipples that protrude too much, or nipple hypertrophy, can be an embarrassment. Ideal nipple size and shape is a subjective issue, which ultimately depends on how your nipple appearance impacts your confidence. We can correct both inverted or protruding nipples to enhance the overall look of your breasts.


You may be a good candidate for a nipple correction if you have one or more of the following issues:

  • Flat nipples that don’t protrude from the breasts
  • Women whose nipples are visible through clothing
  • Women who have finished having children or those who do not plan to breastfeed

Talk With Your Surgeon

While you may not like the idea of breast implants, sometimes they are the best treatment for poorly shaped or sized breasts. An expert surgeon, like Dr. Koch, can provide enhancement using implants that look and feel natural. You should always schedule a consultation with a breast specialist to have an evaluation of your needs. Together, you will develop a breast enhancement plan that will have you looking and feeling amazing.

Can Plastic Surgery Make You Look Like a Celebrity?

Posted on: October 4th, 2017
By: Office of Dr. Todd B. Koch

Reflection of woman checking her skin in bathroom mirrorWith a quick online search, you can find headline after headline talking about the human Barbie, or how a man paid hundreds of thousands of dollar to look like Justin Bieber. While these are extreme cases of celebrity look-alike plastic surgery, the question is still common in more mild ways—“Can you make me look like this person?”

The short answer is, probably not. Most people want only an aspect of a celebrity, like the nose, lips, or cheeks. But setting your expectations for your plastic surgery procedure is more involved than trying to look like a certain person.

Focus on Your Facial Anatomy

Your general anatomy plays a primary role in the type of enhancement we choose for your surgery. When correcting the nose, adding implants, or placing injectables, we want to add to your features. If you don’t have the similar facial structures as the celebrity you want to emulate, chances are altering your nose to match theirs won’t give you the results you desire. In most cases, you’ll simply end up disappointed. It’s better if we make changes that highlight your facial anatomy.

Natural Results Are Goals

While you may want dramatic results, what’s important is that your final appearance looks natural. Nothing is worse than obvious plastic surgery. You want your beauty to look like your own. Your surgeon will make suggestions as to what the best techniques are for your needs, and all changes should be in balance with your facial features. Beautifully flawless results are what we strive to achieve.

Have Realistic Expectations

Thinking your plastic surgery will help you look like a specific celebrity gives you unrealistic expectations. While referring to celebrities for the shape, definition, or size inspiration during your consultation is fine, you should expect your surgeon to recommend changes that fit with your appearance.

For a face, breast, or body consultation, you can contact Dr. Koch today. Call our office at (716) 631-1220, or you can contact us online.


Eliminate My Double Chin

Posted on: September 19th, 2017
By: Office of Dr. Todd B. Koch

3 Kybella treatments 6 weeks apart by Dr. KochThe dreaded double chin is probably one of the most frustrating facial characteristics to change. While many people assume that a double chin develops because of weight gain, the fact is, even fit people can be prone to fat accumulation at the neck. For many, diet and exercise yields little results for improving a double chin. Luckily, there are two techniques available to help give you the facial shape you’ve always wanted.

Liposuction to Treat a Fatty Chin

Liposuction is the most effective form of fat removal available. However, it is considered a surgical treatment, and most people require some form of anesthesia for their treatments. A small incision is created under the chin, which is usually undetectable once healed. With liposuction, we can permanently remove fat from below the chin and provide a sculpted facial appearance in just one treatment.

KYBELLA® for Non-Surgical Double Chin Treatment

KYBELLA® is a newly FDA-approved treatment for the double chin. It is a non-surgical injection that dissolves fat and requires zero post-treatment downtime. KYBELLA® treats patients who have mild to moderate submental fat. While it permanently eliminates fat, its results may not be as consistent as liposuction, and multiple treatments may be necessary to achieve your ideal results.

Am I a Good Candidate?

Any procedure should only be performed on healthy individuals. KYBELLA® and liposuction yield the best results when performed on patients with good neck elasticity. If you have lax neck skin, a neck lift may be considered in combination with your fat removal process. A consultation is needed to determine the most effective double chin treatment for you. Factors such as the amount of fat, areas of accumulation, skin elasticity, and final cost can impact the technique you choose for your treatment.

If you are ready to see which treatment will give you the facial shape you’ve always wanted, schedule a consultation with Dr. Koch. You can call our office at (716) 631-1220, or you can contact us online.

A Back-to-School Treat for You

Posted on: August 22nd, 2017
By: Office of Dr. Todd B. Koch

Mom and schoolgirl of primary school holding handsThe summer season is a hectic time for most moms. Kids full of energy at home 24/7, sports practice, swimming lessons, and activities with friends. You can run yourself ragged over the summer and forget to take any time for yourself. That back-to-school moment can be sad, but it can also provide you with some much-needed time to enjoy the calm. As you send your kids back to school, it might give you the chance to reflect on what you can do for yourself.

The busy lifestyle of a parent may mean that you spend less time focusing on yourself. It is common for us to see moms who are stressed, tired, and unhappy with their appearance. After having your children, restoring your pre-baby body may be more difficult to achieve than you thought. A Mommy Makeover may be just what you need to refresh your appearance and reclaim your confidence.

Mommy Makeover When Your Kids Return to School

It can be difficult to find the perfect time to undergo your Mommy Makeover, but the back-to-school season may be ideal for you. While you will still need help from your partner and friends with a carpool system, you will have long periods alone to recover, and you won’t need to do heavy lifting like if you had a baby still. The peace and quiet you have while the kids are away will help you recover quickly.

Additionally, undergoing a Mommy Makeover in the fall will help ensure that you are fully healed by the time the holidays roll around. You should always plan surgery at least two months before any major event to give enough time for swelling to subside and your results to become noticeable.

What Does Mommy Makeover Surgery Correct?

  • Volume loss: A breast augmentation uses implants to restore lost breast volume that women often experience after nursing.
  • Breast sagging: A breast lift repositions and firms the breasts for a more youthful and revitalized appearance.
  • Abdominal pooch: A tummy tuck can restore a tighter, firmer abdominal contour, which you may struggle to achieve through diet and exercise.
  • Stretch marks: A tummy tuck can also improve the amount and visibility of stretch marks by removing redundant folds of skin on which they are present.
  • Excess fat: Liposuction can treat areas with stubborn fat deposits for a slimmer, toned appearance.

For more information about the Mommy Makeover recovery process, or to schedule a consultation with our board-certified plastic surgeon, contact Dr. Koch today. You can call our office at (716) 631-1220 or contact us online.

Top 3 Reasons for Implant Exchange

Posted on: July 13th, 2017
By: Office of Dr. Todd B. Koch

Implant Exchange Before and After PhotosHave you previously undergone a breast augmentation and still aren’t happy with your results? It can be frustrating to spend the money and time trying to achieve your ideal look only to have your procedure not provide you with the results you want. Dr. Koch sees many women looking to improve their breast augmentation results and recommends implant exchange if you aren’t happy with your breast appearance. These are the top 3 (but certainly not the only) reasons implant exchange may be right for you.

1. Poor Sizing

Ideal breast size varies among women because no two ladies have the same body type or shape. Determining implant size during the augmentation process is a delicate balance of your wants and your existing body proportions. 3D imaging is a very helpful tool in selecting the appropriate size before surgery. Sometimes, the wrong implant size is chosen, resulting in dissatisfaction with breast size after augmentation. You may feel that your breasts are now too large for your frame, or you may still feel that your breasts are too small. With an implant exchange, we can switch out your current implants for ones that will better provide you with the bust size you desire.

2. Implant Damage

Implant damage can occur at any point after your augmentation, whether within the first year of having your implants or 10 years after your initial procedure. While most implant damage is due to age-related wear and tear. Damage to a breast implant can cause a leak or rupture that will result in a deflated, empty breast. If you have saline implants, ruptures are more immediately noticeable, whereas silicone leaks may not be as visible and may require an MRI to diagnose. It is important to exchange damaged implants as soon as possible to preserve your health and the aesthetics of your breast. Newer gel implants are available that will not leak.

3. Unattractive Appearance

As with determining your size, choosing the best implant type and placement for your breast augmentation is based on a number of factors. The wrong choices for your needs and body type can contribute to an unattractive breast appearance. Saline implants may cause visible rippling in some patients, silicone implants may result in prominent implant edges in others, and subglandular placement may create a more noticeably augmented appearance. Dr. Koch will help you determine which implant factor is causing your unattractive breast appearance and will make a recommendation on how to fix it. Sometimes just the implant type needs to be changed. However, changing the placement of your breast implants can also change the positioning and shape of your bustline.


You can find more reasons for implant exchange on our breast revision page. If you would like more information on the implant exchange process or to schedule your breast consultation, you can call Dr. Koch’s office today at (716) 631-1220, or you can contact us online.